Water BirthDecember 09, 2017

In some parts of the world water births have been around for centuries. In the western world it wasn’t until the 1970s that healthcare professionals started looking at water births as a real option for mums-to-be.

If you would like to give birth in a special birthing pool at home or in hospital, then you will need to talk to your midwife to see if this is an option they would recommend for you.

If a complete water birth isn’t possible, you may still be able to use a birth pool or a bath filled with warm water to relax you during the first stages of labour and then get out of the water to give birth.

Birth pools are available in maternity units, or alternatively you can hire one to use at home.

The advantages of a water birth

Mothers report that the warm water helps to ease the pain of contractions and that having a water birth makes you feel more relaxed and comfortable which results in calmer breathing rhythm. Studies have shown that the use of water as pain relief during labour has been found to reduce the need for epidurals as pain relief.*

· A dimmed room and birthing pool may feel more private than a bright labour ward, helping you relax even more

· The buoyancy of the water makes you feel lighter and enables you to get into more comfortable
positions for the final stages or keeping you more upright - which gives you the advantage of working with gravity as your baby is born.

The disadvantages of a water birth

· Pain relief options are more limited

· You may have to leave the pool if a complication at delivery develops

What extra pain relief can I take?

Entonox (gas and air) is allowed during a water birth (the gas is too weak to make you feel so drowsy that you’d slip under the water). In a hospital gas and air is usually pumped into the delivery room or the birth pool room from a central supply. It can be brought to your home, in a cylinder.

Massage and breathing exercises are also fine during a water birth. You will not be allowed TENS (transcutaneous electrical nerve stimulation) as this is electrical and therefore not compatible with water. Nor would you be allowed pethidine, or other injectible drugs which could make you drowsy. An epidural, which involves a fine tube being inserted into your back is also not possible in the birthing pool.

How will it be for your baby?

Babies have a natural ‘dive reflex’ whereby they close their airway and do not take a breath while under water, so you need not worry she is going to swallow a big mouthful of your pool water as she emerges.

Babies born into warm water often appear far more relaxed and often don’t even cry until they are dried and air hits their cheeks. It is thought that the pool feels like the comforting waters of your womb to your baby. Supporters of birthing pools believe that the transition to the outside world is less traumatic for babies who are born in water.

Experts believe that babies are only at risk of inhaling water if:

· their head is brought to the surface before the rest of their body is born, overriding their dive reflex

· their oxygen supply via the placenta is affected in some way

Your midwife will know she needs to be careful as your baby is being born, so that she doesn't interfere with her dive reflex. She'll also guide you to make sure you don't bring your baby's head to the surface before the rest of her body is born.

Are there any risks of infection?

There is no statistical evidence that there is any more risk of an infection with a water birth.

Hospitals are meticulous when cleaning pools after every water birth and do regular checks to ensure that the pool is left hygienic after use.

What are the reasons for not seeing a water birth through to the end?

There are several reasons why you may have to give up on a water birth and resort to a conventional setting. If your contractions are too strong for you and the birthing pool is not making you relax then you may have to give it up and have another pain relief option such as TENS, pethidine or an epidural.

You may have complications. You will be asked to leave the pool if:

· your labour is progressing too slowly

· There is a problem with your baby’s heartbeat

· you start bleeding during labour

· your blood pressure is raised

· If you feel faint or drowsy

Remember your midwives are trained to deal with emergencies and will get you out of the pool quickly if necessary. In a hospital a bed will be ready for you in case you need it and at home you should have your bed prepared in case you have to give up your water birth plan.

Your midwife will also monitor your baby during your labour with a waterproof device to make sure she's getting enough oxygen and that it’s safe for you to continue in the water. Your midwife will monitor you throughout your time in the pool using all her experience as she watches you, talks to you and keeps an eye on your progress tone.

Your blood pressure and temperature will be checked regularly and you may have an internal examination. This can be done while you are in the water, or your midwife may ask to do one after you have been to the toilet, while you are out of the pool.

What about the umbilical cord?

As the baby is lifted from the water by your midwife special care will be taken not to pull on the cord, just in case the cord is shorter than normal.

And after the birth?

Some doctors and midwives have commented on how calm babies are after being born in water crying less than babies born in air, appearing more relaxed, eager to have eye contact with their mothers and to suckle.

How is the placenta delivered?

Many hospitals and birth centres have a policy which requires the mum to get out of the pool for the delivery of the placenta, so if you may be asked to leave the pool for this stage.